Impact of the Relocation of a Long-term Residential Care Facility on Staff.

This article describes the relocation of residents and staff of a long-term residential care facility into a new state-of-the-art building in a Canadian province. All staff were surveyed about their perceptions of the moving process 2 months after the move occurred using a newly created 51-item questionnaire containing both open-ended and closed questions (5-point Likert scale). The results were positive for the 3 subscales of the survey, with average scores for premove, midmove, and postmove items of 3.67, 3.94, and 3.66, respectively. There was no significant difference in the means when comparing staff position, years of employment, or assignment to 1 or more units. Staff were very positive about the move itself, the orientation provided and overall planning, and support from coworkers and management. Some concerns were raised about staffing shortages, involvement of residents, and preparedness of the units and building. In addition, it is evident that relocation is an ongoing process, with many supports required in the months after the move. This article describes a very well planned and executed relocation of a long-term residential care facility and can provide guidance and lessons learned to assist other administrators who are planning a similar endeavor.

Virtual education: is it effective for preparing nurses for a hospital move?

OBJECTIVE: The objective of this study was to compare the effectiveness of using a virtual environment (VE) versus traditional paper floor plans (FPs) to prepare nurses for wayfinding in a new hospital building. BACKGROUND: This study was designed to control for variables such as task complexity and individual ability that have been missed in other media comparison studies. METHODS: Thirty nurses were assigned to the VE or FP condition using a randomized block experimental design. Subjects were blocked by alternate ranks on spatial/navigational ability and computer attitude/experience and randomly assigned to conditions. Nurses received instruction with either a VE or FP condition. Wayfinding tasks were then completed with trained observers at the new hospital under construction. RESULTS: The investigators found no significant differences between the wayfinding performance or postintervention confidence levels of subjects. Instruction using both media improved wayfinding and navigation skills. Qualitative findings suggest that interactions of the instructional style, media, and learner influence information retention and transfer. CONCLUSIONS: Although the virtual media did not prove to be more effective than FPs, it was equally effective for learning wayfinding and navigation skills in a new hospital. Nursing leaders may want to consider use of 3-dimensional VEs as an early method to provide repetitive practice for learning how to navigate a new large-scale space.

Going viral: adapting to pediatric surge during the H1N1 pandemic.

OBJECTIVES: The objective of this study was to assess hospital and emergency department (ED) pediatric surge strategies utilized during the 2009 H1N1 influenza pandemic as well as compliance with national guidelines. METHODS: Electronic survey was sent to a convenience sample of emergency physicians and nurses from US EDs with a pediatric volume of more than 10,000 annually. Survey questions assessed the participant's hospital baseline pandemic and surge preparedness, as well as strategies for ED surge and compliance with Centers for Disease Control and Prevention (CDC) guidelines for health care personal protection, patient testing, and treatment. RESULTS: The response rate was 54% (53/99). Preexisting pandemic influenza plans were absent in 44% of hospitals; however, 91% developed an influenza plan as a result of the pandemic. Twenty-four percent reported having a preexisting ED pandemic staffing model, and 36% had a preexisting alternate care site plan. Creation and/or modifications of existing plans for ED pandemic staffing (82%) and alternate care site plan (68%) were reported. Seventy-nine percent of institutions initially followed CDC guidelines for personal protection (use of N95 masks), of which 82% later revised their practices. Complete compliance with CDC guidelines was 60% for patient testing and 68% for patient treatment. CONCLUSIONS: Before the H1N1 pandemic, greater than 40% of the hospitals in our study did not have an influenza pandemic preparedness plan. Many had to modify their existing plans during the surge. Not all institutions fully complied with CDC guidelines. Data from this multicenter survey should assist clinical leaders to create more robust surge plans for children.

Transitioning to a new nursing home: one organization's experience.

Restructuring of long-term care in Western Health, a regional health authority within Newfoundland and Labrador, created a unique opportunity to study the widespread impacts of the transition. Staff and long-term-care residents were relocated from a variety of settings to a newly constructed facility. A plan was developed to assess the impact of relocation on staff, residents, and families. Indicators included fall rates, medication errors, complaints, media database, sick leave, overtime, injuries, and staff and family satisfaction. This article reports on the findings and lessons learned from an organizational perspective with such a large-scale transition. Some of the key findings included the necessity of premove and postmove strategies to minimize negative impacts, ongoing communication and involvement in decision making during transitions, tracking of key indicators, recognition from management regarding increased workload and stress experienced by staff, engagement of residents and families throughout the transition, and assessing the timing of large-scale relocations. These findings would be of interest to health care managers and leadership team in organizations planning large-scale changes.

[The worries and anxieties of nurses involved in the reorganization of a department]. / Le preoccupazioni degli infermieri coinvolti in un progetto di riorganizzazione dipartimentale.

INTRODUCTION: The change process generally elicits reactions not always positive, although expected. AIM: To describe the reactions to change before and after one year from implementation. METHODS: A questionnaire was administered to a group of nurses before and after their wards was moved to a new surgical department with a totally different organization. RESULTS: The nurses remained moderately worried before and after the change. Worries for the impact of the change on the patients and themselves significantly increased. Nurses with 4-14 years of experience expressed higher levels of concern. CONCLUSIONS: The worries are a normal reaction but their better understanding may give indications on support strategies.

Your hospital is moving: concerns for the security leader.

The security staff is the key to the successful move of an entire hospital to a new facility, the author says. Planning for the move will force a security department to take on issues that have never been considered, he adds. In this article, he presents those security and safety issues for managers and directors to thoroughly examine and review.

Moving day: a case history.

Utilizing an Incident Command structure and organizational chart, a health system successfully moved 144 patients and related services to a new facility 3.5 miles away in four hours. In this article, the author describes the planning that was involved and the key role that was played by the Security Department.

Leading complex change in healthcare: 10 lessons learned.

This article reports on the transfer of perinatal services at St. Joseph's Health Care, in London, Ontario, to London Health Sciences Centre (LHSC). The transfer of perinatal programs, services and people/providers to LHSC generates concern in key stakeholders with respect to a potential negative impact on the quality of care delivery, staff work life and morale, team performance, recruitment, retention and other performance indicators. Our main task was to establish "readiness and capacity for the change" in the years leading up to the actual transfer, with a strong focus on attending to the human side of the change, clinical and cultural alignment. We describe the external and internal challenges of the transfer and the approach that we took in building readiness, and end with 10 lessons learned and applied throughout the change process.

Effect of Relocation on Neuropsychiatric Symptoms in Elderly Adults Living in Long-Term Care.

OBJECTIVES: To determine the evolution of behavioral and psychiatric symptoms of dementia (BPSD) in nursing home (NH) residents after an environmental change through a relocation to a more architecturally suitable facility, while conserving the same medical staff. DESIGN: Prospective, single arm study. SETTING: Long-term care unit. PARTICIPANTS: NH residents (N=116; median age 82.3, range 75.5-89.2; median Neuropsychiatric Inventory for the Nursing Home (NPI/NH) score 22, range 11-34.5; 66.3% female), of whom 102 lived in regular units and 14 in specialized care units (SCUs). MEASUREMENTS: Neuropsychiatric symptoms were evaluated as part of a comprehensive geriatric assessment for each resident 1 week before the relocation and 3 times after the relocation (1, 4, 12 weeks) using the NPI/NH. RESULTS: A mixed-effect linear model found no significant change in global NPI/NH score in the regular unit and a significant decrease in overall NPI/NH score 4 weeks after relocation in the SCUs (ß-coefficient for time by SCU=-11.5, 95% confidence interval (CI)=-17.9-5.2, p < .001), reaching a total decrease of 13 points by 12 weeks after relocation (ß-coefficient for time by SCU=-12.8, 95% CI=-19.1-6.4, p < .001). A statistically significant decrease of 3 points for disinhibition, apathy, and agitation accompanied the NPI/NH score in the secured unit. An increase of 3 points in aberrant motor behavior was seen by 12 weeks after relocation in the SCU. CONCLUSION: Relocation to an architecturally different facility significantly reduced BPSD of NH residents 1 month after relocation. J Am Geriatr Soc 66:2183-2187, 2018.

It Takes a Village to Move a Hospital: Simulation Improves Intensive Care Team Preparedness for a Move to a New Site.

OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing. RESULTS: Response rates were initially 100% and 67% at the 6-month follow-up. In the initial phase, all questions had statistically significant improvements in post- versus presimulation scores. Participants felt better prepared (presimulation: 6.20, postsimulation: 7.90, P < .001) and more confident about caring for real patients (presimulation: 5.49, postsimulation: 7.41, P < .001). They felt more comfortable working in the new unit (presimulation: 5.65, postsimulation: 7.50, P < .001) and better able to deliver safe care (presimulation: 5.85, postsimulation: 7.60, P < .001). Six months postmove, participants still believed that simulation was helpful (7.43, SD: 2.20) and still reported improved team confidence (7.36, SD: 2.11). Only 1 of 28 participants preferred less simulation. Exercises were described as helpful in identifying process and latent patient safety issues. CONCLUSIONS: Our pediatric intensive care team found simulations to be beneficial in preparation for providing care to critically ill children in a complex new setting. Simulations uncovered latent process, personnel, and patient-safety issues that were addressed before actual patient care.

Moving with ease.

To ensure a hospital move is successful, years of painstaking planning must take place; and materials managers should be involved from the time the decision is made by executives until the move is complete. Attention to detail is critical because everything from materials to patients will be affected. So, to ensure the move is both safe and cost efficient, materials managers should take advantage of the lead time to communicate with other departments and other hospitals that have made moves to learn from their experiences.

Moving a hospital: simulation - a way to co-produce safety healthcare facilities.

Moving a hospital is a critical period for quality and safety of healthcare. Change is very stressful for professionals. Workers who have experienced relocation of their place of work report deterioration in health status. Building a new hospital or restructuring a unit could provide an opportunity for improving safety and value in healthcare and for ensuring better quality of worklife for the staff. We used in situ simulation to promote experiential learning by training healthcare workers in the workplace in which they are expected to use their skills. In situ simulation was a way to design, plan, assess and implement a new healthcare environment before opening its doors for patient care. We can envisage that simulation will soon be used formally to identify potential problems in healthcare delivery and in staff quality of worklife in new healthcare facilities. Simulation is a way to co-produce a safe and valuable healthcare facility.

Hospital construction 101: blueprints for success.

Nursing input from beginning to end proves crucial to success of new healthcare construction or remodeling projects. Here, explore pointers to ensure optimal results.

Moving a hospital--a once in a lifetime experience.

It is a hugely complex task to move a 525-bed acute tertiary health facility to a new building whilst continuing to provide services to the public--a task that was undertaken at Brisbane's Princess Alexandra Hospital in March/April 2001. There were complex issues to manage, ranging from clinical unit interdependence across a split campus to the development of detailed plans for transferring telephone extensions/personal computers in a "live environment". The success of the Princess Alexandra exercise is shown by there having been no adverse effects on patients, the lack of negative media attention and the occurrence of only two staff injuries during the move. Meticulous planning and good communication with staff and stakeholders (other hospitals, general practitioners) supported this success. The decision to reduce clinical services where possible during the shift was helpful. Understanding the complexity and richness of the information technology, the work environment and the human elements on campus was also critical to success. One major error was the initial decision to schedule the move within weeks of receiving practical completion of the new building. It became all too clear in November 2000 that further time was required to commission the building. The Transition was therefore rescheduled from January to March 2001. This decision was critical to the success of the move.

Building a 21st century facility.

At Chicago's Northwestern Memorial Hospital, staff worked for 10 years to design a new facility and plan the transition for their patients, their equipment, and themselves.

Ask AONE's experts ... about how to plan a transition to a new facility.

Building a new facility requires careful planning based on consumers' needs and desires.

Moving day doesn't begin (or end) on moving day.

Making the transition from an old setting to a new one includes much more than changing the place people report to work. Besides touring the new setting, nursing personnel should decide on locations for stock supply areas, as well as "experiencing" the unit before actual moving of patients. No policy and procedure changes should be made at this time except those directly related to the move. Strong leadership is essential during this stressful time.